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World J Gastroenterol. Apr 21, 2008; 14(15): 2401-2405
Published online Apr 21, 2008. doi: 10.3748/wjg.14.2401
Is there correlation between pancreatic enzyme and radiological severity in acute pancreatitis?
Yeon Soo Kim, Byung Seok Lee, Seok Hyun Kim, Jae Kyu Seong, Hyun Yong Jeong, Heon Young Lee
Yeon Soo Kim, Departments of Internal Medicine, Daejeon St. Mary’s Hospital Medical College of the Catholic University of Korea, Korea
Byung Seok Lee, Seok Hyun Kim, Jae Kyu Seong, Hyun Yong Jeong, Heon Young Lee, Department of Internal Medicine, Chungnam National University Hospital, Daejeon 301721, Korea
Author contributions: Kim YS, Lee BS wrote the paper and organized the figures and patient data; Kim SH, Seong JK and Jeong HY helped write, organize, and correct the paper; Lee HY supervised the writing and organization process.
Correspondence to: Byung Seok Lee, MD, Department of Internal Medicine, Chungnam National University Hospital, Dae Sa Dong 640, Jungu Daejeon city 301721, Korea. gie001@cnuh.co.kr
Telephone: +82-42-2207125
Fax: +82-42-2544553
Received: June 27, 2007
Revised: February 19, 2008
Published online: April 21, 2008

AIM: To investigate the correlation between the changes of pancreatic enzyme, the biochemical markers and the clinical results according to the Balthazar computer tomography (CT) grade.

METHODS: Between July 2004 and July 2005, we reviewed the charts of 119 patients who were admitted to our hospital with acute pancreatitis.

RESULTS: Eighty-three patients (69.7%) were male, and the mean age of the patients was 57 ± 15.7 years. The biliary pancreatitis patients had an older mean age. Forty-nine patients (41.1%) had biliary pancreatitis and forty-six (38.6%) had alcoholic pancreatitis. Group 3 patients had a longer duration of pain (2.51 ± 1.16 vs 3.17 ± 1.30 vs 6.56 ± 6.13, P < 0.001), a longer period of fasting (7.49 ± 4.65 vs 10.65 ± 5.54 vs 21.88 ± 13.81, P < 0.001) and a longer hospital stay (9.17 ± 5.34 vs 14.63 ± 8.65 vs 24.47 ± 15.52, P < 0.001) than the other groups. On the univariate analysis, the factors that affected the radiological grade were the leukocyte count at admission (P = 0.048), the hemoglobin (P = 0.016) and total bilirubin concentrations (P = 0.023), serum lipase (P = 0.009), the APACH II scores at admission (P = 0.017), the APACH II scores after 24 h (P = 0.031), the C-reactive protein (CRP) titer (P = 0.0001) and the follow up CRP titer (P = 0.003). But the CRP level (P = 0.001) and follow up CRP titer (P = 0.004) were only correlated with the radiological grade on multivariate analysis. According to the ROC curve, when we set the CRP cut off value at 83 mg/L, the likelihood ratio for a positive test was 3.84 and the likelihood ratio for a negative test was 0.26 in group 3.

CONCLUSION: In conclusion, our study suggests that the CRP with the radiological severity may be used to estimate the severity of acute pancreatitis.

Keywords: Acute pancreatitis, Computed tomography, C-reactive protein